While I would love to see something like this implemented, it would require tracking changes as Steve makes them to implement. And if you have already run into some errors that the patch is supposed to fix, there may be corruption in the database that get transferred to the upgraded one. That would/could make bug troubleshooting more difficult and something else Steve may not feel like spending time doing.
On a related side note, given the 'are you on the current db' or 'db/.exe didn't overwrite' comments I've seen in the bugs threads, maybe putting a DB version field in that the .exe checks on startup with a 'incompatible db version error' that prevents the .exe from using an incorrect db would be useful.